In recent years, the use of laparoscopic instruments to perform minimally-invasive surgical procedures has become increasingly popular. In such procedures, a device termed a laparoscope, having an elongated substantially tubular member is inserted into the body of the patient through a relatively small incision in the skin. The distal end tube or "cannula" is positioned proximate an area inside the body upon which a surgical procedure is required. The distal end generally includes a lens and, typically, a light source to illuminate the interior of the body. The lens transmits received images from inside the body to a camera located, generally, outside of the body near a proximal end of the cannula. The camera may be interconnected to a video monitor so that a surgeon may view the operation area. Hence, the surgeon may view an interior portion of the body without the need of a large incision to open an area to external viewing.
Several additional laparoscopic instruments, also having elongated tubular cannuli, may be inserted through additional incisions in the skin to positions adjacent the laparoscope's distal end. These instruments may include a number of surgical tools including scissors, graspers and retractors capable of mechanical movement to perform desired surgical operations upon the area. The laparoscope allows the surgeon to view the progress of the instruments and, hence, guide the other laparoscopic instruments to perform the operation.
Conventional surgical procedures in which the surgeon performs the operation through an open incision, using hand tools such as scalpels and forceps, generally inflict significantly more trauma upon the patient and entail a more lengthy recovery time than for the relatively minor incisions necessitated by laparoscopic instruments. Thus, for many types of surgery, the use of laparoscopic instruments is largely preferred.
A disadvantage to the use of laparoscopic instruments, however, has been the need for a substantial number of operators in order to effectively employ the procedure. To date, most Laparoscopes and laparoscopic instruments have been designed strictly for hand-held manual operation. Some laparoscopes have utilized supports to aid in holding them stationarily, but insertion, retraction and readjustment of the cannula has been performed manually. Each instrument usually must be operated by a single staff member and that staff member must maintain the instrument in a proper location throughout the procedure by manually readjusting it as needed. For example, the camera may require frequent refocusing and redirecting. In addition, instruments having tools that require manipulation must be operated by the user while the user simultaneously holds the laparoscope at an appropriate location which can tax the coordination of the user and quickly fatigue him or her.
The continual manipulation of instruments by hand, therefore, can seriously impede the efficiency of an operating staff, particularly during a long and difficult procedure.
In view of the disadvantages associated with the use of manually operated laparoscopic instruments, this invention has, as one object to provide a laparoscopic instrument that may be operated remotely by the user. This invention also enables more accurate and stable movement of laparoscopic tools relative to an area of operation and allows manipulation of a greater number of laparoscopic instruments by fewer users than manually-operated laparoscopic instruments. This invention also reduces operating staff fatigue by automating more of the control and movement functions necessary in laparoscopic surgery.